Annals of the American Thoracic Society
-
The implementation of team-based care models in residency programs is one method to improve patient and provider outpatient satisfaction. However, to our knowledge, this has not yet been studied in fellowship programs. ⋯ The Fellow of the Day role was successfully implemented at our institution with multiple benefits, not only to fellows but also to patients, medical students, and supervising faculty. Our education committee has recommended continuation of the role in our fellowship program.
-
Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. ⋯ Residency programs have instituted creative solutions to encourage more internal medicine residents to pursue careers in subspecialty medicine. Some solutions include creating rotations that promote more contact with subspecialists and physician-scientists, creating clinician-educator tracks within fellowship programs, and appointing subspecialists to internal medicine residency leadership positions. We need more rigorous research to track the trends and implications of the generalist-specialist balance of inpatient ward teams on resident career choices, and learn what interventions affect those choices.
-
Point-of-care lung ultrasound imaging has substantial diagnostic value and is widely used in respiratory, emergency, and critical care medicine. Like other ultrasound examinations, lung ultrasound is operator dependent. The current recommendations for competence in lung ultrasound set a fixed number of ultrasound procedures to be performed without considering different learning rates. Recommendations do not consider different uses of lung ultrasound across specialties. ⋯ This assessment tool provides a relevant, valid, and feasible method for evaluation of operator competence in point-of-care lung ultrasound across multiple specialties. This allows for a more individualized assessment of competence than current recommendations.